Urology Care

Self-Catheterization Guidelines for Men

Reference guides can be extremely helpful for patients with urological issues to understand how to catheterize and sanitize. (Note: When using a coudé catheter, the curved tip must be facing upward, toward your navel.)

  1. Wash your hands and your penis with warm, soapy water or a moist towelette.
  2. Lubricate the tip of the catheter. Place the opposite end of the catheter in the toilet or basin. (For a coudé, lubricate the first few inches of the catheter. If using a hydrophilic catheter, please consult the manufacturer information for lubrication instructions.)
  3. Hold the tip of your penis at a 45° angle from your stomach. Slowly insert the catheter into your urethra. If it is hard to insert, relax. (For a coudé, hold the tip of penis at a 90° angle and insert the catheter with the curved tip facing upward, toward your navel. Some catheters have a guide stripe or dot; make sure this mark is facing up while inserting.) If you feel a sharp pain, remove the catheter and try again. When urine begins to flow, stop inserting the catheter and lower your penis.
  4. When the urine stops flowing, slowly remove and discard the catheter. Be sure to wash your hands.

Hints & Tips

  • Drink plenty of fluids.
  • Always use a clean or sterile catheter.
  • Follow your schedule whether you feel the need to urinate or not.
  • Keep a log of your self-catheterization schedule.
  • Relax.

When To Call the Doctor Even though self-catheterization is safe, occasionally problems may arise. Call your doctor if you experience any of the following symptoms:

  • Blood in your urine
  • Little or no urine
  • Foul-smelling urine
  • Sand-like particles in your urine
  • Leakage between catheterizations
  • Pain when inserting catheter
  • Lower back or abdomen pain
  • Low-grade fever of 100.4° or higher

Direct any medical questions to a health care professional. Always consult with your physician before modifying any course of treatment.

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Self-Catheterization Guidelines for Women

Reference guides can be extremely helpful for patients with urological issues to understand how to catheterize and sanitize.

  1. Wash your hands and your genitals with warm, soapy water or a moist towelette. Make sure you wash from front to back.
  2. Lubricate the tip of the catheter. Place the opposite end of the catheter in the toilet or basin.
  3. Spread the labia and find your urethra with a mirror or your index finger. Slowly insert the catheter into your urethra. If it is hard to insert, relax. When urine begins to flow, stop inserting the catheter.
  4. When the urine stops flowing, slowly remove and discard the catheter. Be sure to wash your hands.

Hints & Tips

  • Drink plenty of fluids.
  • Always use a clean or sterile catheter.
  • Follow your schedule whether you feel the need to urinate or not.
  • Keep a log of your self-catheterization schedule.
  • Relax.

When To Call the Doctor Even though self-catheterization is safe, occasionally problems may arise. Call your doctor if you experience any of the following symptoms:

  • Blood in your urine
  • Little or no urine
  • Foul-smelling urine
  • Sand-like particles in your urine
  • Leakage between catheterizations
  • Pain when inserting catheter
  • Lower back or abdomen pain
  • Low-grade fever of 100.4° or higher

Direct any medical questions to a health care professional. Always consult with your physician before modifying any course of treatment.

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Urinary Tract Infections

At times Urinary Tract Infections (UTIs) can occur. There are typical symptoms that may indicate you have a UTI. If you develop a fever or have one or more of these, contact your doctor.

UTI Symptoms

  • Hypertension (blood pressure greater than 200/100)
  • Fever
  • Chills
  • Leakage or voiding between catheterizations
  • Increased spasms of legs, abdomen, or bladder
  • Feeling the need to catheterize more often
  • Feeling the need to catheterize immediately
  • Burning feeling in your urethra, penis, or pubic area
  • Nausea
  • Headache
  • Lower back pain
  • Sediment or mucus in your urine
  • Foul-smelling or cloudy urine
  • Blood in your urine
  • Autonomic dysreflexia

Direct any medical questions to a health care professional. Always consult with your physician before modifying any course of treatment.

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Skin Infections

As the largest organ in your body, your skin protects you from bacteria, dirt, and the sun's ultraviolet rays. It also contains the nerve endings for sensation and plays a key role in regulating your body's fluids and temperature. A good skin care program can help you avoid the consequences of pressure sores, including pain and hospitalization.

Tips To Keep Your Skin Healthy

  • Keep your skin clean and dry.
  • Avoid soaps labeled "antibacterial" or "antimicrobial."
  • Avoid items that may dry your skin, such as harsh soaps.
  • Lubricate dry skin with moisturizers or ointments.
  • Immediately clean any urine or stool that may come in contact with your skin.
  • Avoid using talcum powders, which can support yeast growth.
  • Maintain a healthy weight.
  • Stop smoking.
  • Avoid excessive exposure to the sun and use an effective sunscreen.
  • Use extra care to avoid bumping into things.
  • Avoid excessive temperatures, hot or cold.
  • Maintain proper nail care.
  • Avoid tight fitting clothes, right shoes or socks that blind.
  • Wash new clothing before wearing it.
  • Elevate hands, legs, and feet frequently, if you notice any swelling.
  • Change clothing as soon as it becomes wet or soiled.
  • Eat a well-balanced diet and maintain adequate fluid intake.

Direct any medical questions to a health care professional. Always consult with your physician before modifying any course of treatment.

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Spasticity

Spasticity, or muscle spasms, is an exaggeration of the normal reflexes that occur when your body is stimulated in certain situations. It can occur any time your body is stimulated below the level of a spinal injury. Spasticity may come in the form of a rigid straightening of your knees and pointing of your toes (extensor spasms) or in a bending of your hip and knees (flexor spasms).

Almost anything can trigger spasticity. An increase in spasticity is one of the ways your body warns you of pain or problems, such as a pressure sore or urinary tract infection (UTI). Spasticity also helps your body maintain muscle mass and bone strength, as well as promote circulation, so it's possible to learn to use spasticity to help you in transferring or performing other tasks.

Care

  • Perform a daily range of motion exercise program.
  • Take precautions to prevent UTIs and skin breakdown.
  • Avoid injuries to your feet and legs.
  • Relax and try to reduce your level of stress.
  • Avoid those things that stimulate or aggravate your spasticity.

If your spasticity begins to interfere with your daily functions, such as driving or sleeping, talk with your doctor. Remember, if you experience significant increases or decreases in spasticity, it may be your body telling you that something is wrong.

Direct any medical questions to a health care professional. Always consult with your physician before modifying any course of treatment.

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Range of Motion Exercises

Because people with paralysis do not have the ability to move all parts of their bodies, it is important to perform regular range of motion exercises. An effective range of motion exercise program can help you avoid contractures (permanently shortened range of motion in a joint), spasticity (muscle spasms), and pressure sores, while improving posture and trunk stability.

Failure to exercise on a regular basis can cause your joints, muscles, ligaments, and tendons to stiffen, which will impact your ability to sit and maintain posture. Lack of exercise can result in increased muscle spasms and increase your chances of developing pressure sores.

If you are not currently performing range of motion exercises, talk with your doctor, physical therapist or occupational therapist, as well as your caregiver, about a program that will meet your needs. You and your caregiver should understand the correct way to perform each exercise to achieve the desired results and not cause injury.

Sample Range of Motion Exercises

  • Wrist, finger, thumb and elbow abductions (spreading your fingers apart), flexions (bending your wrist, finger or thumb inward toward your palm), and extensions (extending your fingers, wrist and thumb outward, away from your palm)
  • Heel extensions
  • Leg rotations
  • Hip flexions and extensions
  • Straight leg raises
  • Trunk rotations and bending
  • Shoulder rotations and extensions

Direct any medical questions to a health care professional. Always consult with your physician before modifying any course of treatment.

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Wheelchair Cushion Maintenance

The wheelchair cushion is a very important piece of equipment. It helps to properly position you in your chair, provides the proper level of support, and helps to reduce pressure to bony areas of your body, which in turn prevents or reduces pressure sores. Regular routine maintenance of your cushion is required in order to prolong its use and to ensure it will work properly for you.

Examine your skin twice daily for any discoloration which could be the beginning of a pressure sore. Skin discoloration may be an indication that your cushion is not providing the proper level of support and needs to be replaced. As a general rule, most cushions should last for approximately five years, if you take care of them.

Maintenance

  • Clean the cushion according to the manufacturer's guidelines.
  • Most cushions have a cover that can be removed for cleaning. The cover should be cleaned in a washing machine. After washing the cover, it can be dried using the "air" setting. Do not place the cover in a commercial dryer. They dryer can cause heat damage.
  • Air cushions should be inspected weekly for leaks.
  • Gel cushions should be checked monthly for leaks.
  • Foam cushions should be checked monthly for areas where the foam is compressed and cannot provide the proper level of support.

Direct any medical questions to a health care professional. Always consult with your physician before modifying any course of treatment.

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Bowel Management

People with paralysis may experience damage to the nerves that control bowel movements. Whether the problem is a reflex bowel or a flaccid bowel, both types can be managed successfully to prevent unplanned bowel movements and other problems, such as constipation, diarrhea, or impaction.

If your bowel management program begins to produce less than desired results or if you are experiencing more frequent bowel accidents, contact your doctor.

To Ensure Success with your Bowel Program

  • Avoid the use of oral stimulant laxatives.
  • Avoid full-size enemas, which are too irritating to the bowel for use on a regular basis. Use "mini-enemas," which only have a few drops of stool softener.
  • Maintain your bowel program on a regular, predictable schedule.
  • Do not rush; be patient. Allow enough time and privacy to complete your bowel program.
  • Try to maintain your bowel program at the same time each day. This will help you avoid accidents.
  • Do not perform more than four digital stimulations at a time.
  • Trim long fingernails to avoid damage to the rectal tissue.
  • Eat a well-balanced diet with high fiber foods.
  • Adhere to an exercise program (range of motion exercises).
  • Perform your bowel program after a meal or hot beverage. This will help stimulate a bowel movement.
  • If possible, transfer to a toilet. Gravity will assist you in emptying your bowel.
  • Before cleaning, conduct a final check of the rectum to ensure it is empty.
  • Wash and dry the area before getting dressed.

Direct any medical questions to a health care professional. Always consult with your physician before modifying any course of treatment.

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